Provider Demographics
NPI:1922189703
Name:HEYDON-WRATHER, NORMA J (MHS,CCC,SLP)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:J
Last Name:HEYDON-WRATHER
Suffix:
Gender:F
Credentials:MHS,CCC,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1036
Mailing Address - Country:US
Mailing Address - Phone:301-722-6073
Mailing Address - Fax:
Practice Address - Street 1:6500 THAYER CTR
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:MD
Practice Address - Zip Code:21550-1116
Practice Address - Country:US
Practice Address - Phone:301-334-1863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03475235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1069064OtherWV WORKERS COMPENSATION
WV3810004195Medicaid
MD0007442784OtherAETNA
MD61998505OtherCAREFIRST BCBS
MD00016OtherFEDERAL BCBS
MD7946744OtherCIGNA